What is the difference between Medicaid and the Tufts Health RITogether plan?

Rhode Island’s Medicaid program is a joint state and federal program. It pays for health care costs for eligible Rhode Island residents.

Tufts Health RITogether is one of several health plans you can choose from once you are approved for Medicaid. Tufts Health RITogether offers all the benefits of Rhode Island’s Medicaid program, plus great EXTRAS.

What benefits will I get with Tufts Health RITogether?

Tufts Health RITogether offers all the health benefits of Rhode Island’s Medicaid program, plus great EXTRAS. Our EXTRAS include gift cards for car seats, money back on gym memberships and fitness activities, and much more.

We contract with a large network of primary care providers, specialists, hospitals and health centers across the Ocean State. To find out if your doctor or health care provider accepts Tufts Health RITogether, use our Find a Doctor, Hospital or Pharmacy tool. Or give us a call at 1.866.738.4116 (TTY: 711), Monday through Friday, from 8 a.m. to 6 p.m.

How do I choose a doctor or know which doctors I can see?

All Tufts Health RITogether members need to have a primary care provider (PCP). Your PCP coordinates your care, and arranges most or all of your covered services.

Please call us at 1.866.738.4116 (TTY: 711), Monday through Friday, from 8 a.m. to 6 p.m., if you need help.

How does Tufts Health Plan manage my care?

We want to make sure you get the right care in the right place at the right time. We want to make sure you get the best care possible. We work with you and your providers to make a plan for when you leave a hospital or nursing facility. In addition, we have:

A care management program if you need extra support because of a physical disability or a special health condition, such as a high-risk pregnancy, cancer, HIV/AIDS or a behavioral health (mental health and/or substance use) disorder. Our care management team can give you information and resources (if eligible). Team members also can help coordinate your care.

Social care management services if you need more than medical care. Members of our team can help arrange, coordinate and evaluate the social services you may need.

Disease management programs if you have asthma, diabetes or other chronic conditions.

Health coaching services if you have a chronic health condition.

How much does Tufts Health RITogether cost?

Tufts Health RITogether is a Rhode Island Medicaid plan. It provides high-quality health coverage to eligible Rhode Island residents, but there are no costs for members.

How long will I be a member of Tufts Health RITogether?

You need to renew your eligibility with the Rhode Island Medicaid program every year to keep your benefits (and stay enrolled in Tufts Health RITogether). Medicaid eligibility renewal is sometimes done automatically if your income or family size hasn’t changed. You can continue to be enrolled in Tufts Health RITogether as long as you are Medicaid eligible.

How do I join?

Not a Rhode Island Medicaid member?

You’ll need to apply for the Rhode Island Medicaid program first. You can call HealthSource RI at 1.855.840.4774(TTY: 1.888.657.3173), Monday through Friday, from 8 a.m. to 6 p.m. They can talk with you about your eligibility and help you apply. Or you can apply online at healthsourceri.com.

Does the plan cover my medications?

You’ll need to check the following documents or call us to see if your medications are covered. Many prescription and over-the-counter medications are covered. Please see the following documents for more information about pharmacy coverage:

We are required by law to keep your individual health information, known as protected health information (PHI), private and secure. That includes all oral, written and electronic PHI. We do many things to protect your PHI.

We may share your PHI with the providers who treat you, government agencies that review our quality of care and the Rhode Island Medicaid program. Sometimes we need your written permission to release your PHI. You have the right to approve any release of your PHI beyond the exceptions allowed or required by law.